钬激光前列腺剜除术治疗良性前列腺增生合并膀胱过度活动症的临床观察

目的 探讨钬激光前列腺剜除术治疗良性前列腺增生(BPH)合并膀胱过度活动症(OAB)的临床效果.方法 2007年5月至2010年5月,应用钬激光前列腺剜除术治疗BPH合并OAB患者37例,年龄52～89岁,平均(76±3)岁.术后3～6个月之内复查尿流率和残余尿量,术后平均随访4.9个月,通过国际前列腺症状评分(IPSS评分)、生活质量(QOL)评分、最大尿流率(Qmax)、残余尿量、影像尿动力学评价疗效.结果 本组患者术前平均IPSS评分29.6±5.2,术后下降到4.6±1.2.术前平均QOL评分4.3±0.9,术后下降到1.2±1.0.术前平均Qmax为(6±3)ml/s,术后升高到(21±5)ml/s.术前残余尿量平均(167±11)ml,术后下降到(41±18)ml.随访期间86.5%的患者OAB症状及生活质量改善,但仍有13.5%的患者术后OAB症状持续存在.结论 合并OAB的BPH患者存在明确膀胱出口梗阻时,可以首先解除膀胱出口梗阻,但术后仍有部分患者残留有OAB症状.

Clinical observation of holmium laser enucleation of the prostate in the treatment of benign prostatic hyperplasia and overactive bladder

Objective To evaluate clinical efficacy of holmium laser enucleation of the prostate in the treatment of benign prostatic hyperplasia (BPH) and overactive bladder (OAB). Methods From May 2007 to May 2010, a total of 37 patients diagnosed BPH and OAB were treateded by holmium laser enucleation of the prostate. After a mean follow-up of 4. 9 months postoperatively, indices such as International Prostate Symptom Score (IPSS), quality of life (QOL) score, maximum flow rate ( Qmax),residual urine volume and video urodynamics were monitored and statistically analyzed. Results The mean preoperative IPSS and QOL score were 29. 6 ± 5.2 and 4. 3 ± 0. 9, and decreased to 4. 6 ± 1.2 and 1.2 ± 1.0 postoperative. The mean Qmax was (6 ± 3 ) ml/s preoperative and increased to (21 ± 5 ) ml/s postoperative. Preoperative average residual urine volume was (167 ± 11 ) ml,decreased to (41 ± 18)ml after operation. During follow-up, 86. 5% patients' symptoms and quality of life improved continuously,however 13.5% patients existed residual postoperative OAB symptoms. Conclusions When BPH with OAB patients exist bladder outlet obstruction, bladder outlet obstruction should be relieved first then OAB symptoms can be relieved in majority of patients, but some patients have residual symptoms.